Background <p>Chronic rhinosinusitis (CRS) is a complex disorder influenced by both environmental and genetic factors. Due to incomplete understanding of its pathophysiology, effective treatment remains challenging. Microribonucleic acids (miRNAs) have emerged as one of the promising epigenetic regulators, with increasing evidence supporting their role in modulating multiple diseases. This insight might inform future research directions toward the development of miRNA-based biomarkers and therapies.</p> Objective <p>This comprehensive scoping review summarizes the current literature on the functions of miRNAs as epigenetic regulators in CRS.</p> Methods <p>A comprehensive literature review from PubMed database, focusing on chronic rhinosinusitis/nasal polyps and microRNA/miRNA.</p> Results <p>Numerous clinical, in vivo, and in vitro studies have identified altered miRNA levels in CRS, and distinct profiles between type 2 and non-type 2 endotypes of CRS. Several studies revealed positive correlations between miRNAs and symptom scores, objective disease measurements, and polyp recurrence. Certain in vivo and in vitro studies also demonstrated the effects of miRNAs changes mainly on inflammation and tissue remodeling, such as epithelial-mesenchymal transition, or fibrin deposition in nasal polyps. The most researched miRNAs in which involved these mechanisms include <b>miR-125b</b>,<b> miR-155</b>, <b>miR-21</b>, and <b>miR-145-5p</b>. miRNAs also have been shown to contribute to other CRS-related processes, including increased mucus secretion and vascular permeability. Collectively, these findings support the effects of miRNA on CRS development. However, a few studies indicated contradictory results, suggesting that miR-21 has a role in anti-inflammation.</p> Conclusion <p>Increasing evidence highlights the role of miRNAs in CRS pathogenesis. Further research on miRNA-based biomarkers and therapies is warranted.</p>